Rectal Chlamydia trachomatis and Neisseria gonorrhoeae Infections Among Women Reporting Anal Intercourse

Abstract

Genital testing alone misses approximately one fifth of C trachomatis and N gonorrhoeae infections in women reporting receptive anal intercourse in our study population. Missed rectal infections may result in ongoing transmission to other sexual partners and reinfection.

Reduced sensitivity from pooled urine, pharyngeal and rectal specimens when using a molecular assay for the detection of chlamydia and gonorrhoea near the point of care

“…1 Both CT and NG can infect multiple anatomical sites, including urogenital, pharyngeal and anorectal sites in males and females. [2][3][4][5][6][7] Infections are transmissible and often asymptomatic, 8 so early detection and treatment of CT and NG rely on regular, comprehensive and effective testing of multiple anatomical sites for those at risk. 4 For men who have sex with men (MSM), it is recognised that individuals may present with rectal and pharyngeal infections in the absence of genital infection.…”

“…More recently, several studies have indicated the need to screen for rectal CT and NG among women, 3,4,[10][11][12] even in the absence of specific risk factors. 7,13 However, testing multiple anatomical sites from the same person can increase costs and workload, and can be particularly onerous if trying to implement screening at or near the point of care (POC). To minimise testing costs and workload, three studies (n = 1064, 14 n = 100 15 and n = 107 16 ) have investigated whether individual specimens from multiple anatomical sites can be pooled into one combined specimen for molecular testing.…”

Childhood Traumatic Experiences and Receptive Anal Intercourse Among Women

“…(Wave 2 was not included because it was very close in time to Wave 1, did not include the Wave 1 participants who had graduated from high school and included a small number of participants who were not in Wave 1.) This resulted in a sample of 4,876 out of the original 6,684 female participants with survey weights at these waves; the biggest reasons for data loss were participants whose parents did not participate in the Wave 1 parent interview (939) and participants who did not supply data for all nine childhood trauma indicators (1,410); these exclusion categories overlapped. Participants were not excluded on the basis of sexual experience; the vast majority (97%) had engaged in some form of sexual activity (e.g., oral sex or vaginal intercourse) by Wave 4.…”

“…Evidence supports the role that RAI plays in HIV risk among gay and bisexual men, but it may also play a crucial role in driving the heterosexual HIV epidemic, including among women . Other STDs, such as chlamydia and gonorrhea, are also prevalent among women who report engaging in anal intercourse …”

“…In 2016, women accounted for approximately 20% of new HIV cases in the country; about 80% of these were attributed to heterosexual sexual contact. 1 Receptive intercourse, both vaginal and anal, results in a higher risk of HIV infection than does insertive intercourse, and receptive anal intercourse (RAI) confers the greatest risk 2 on the male or female receptive partner. 3 Compared with the vagina, the anus is more vulnerable to abrasions during sex, which facilitates infection transmission, 4 and anal mucosa lacks immune barriers to protect against infection.…”